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Prison Overcrowding: Does It Affect Mental Health?

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In California, the U.S. district court has ordered that tens of thousands of prisoners be released to reduce overcrowding. The case, Schwarzenegger v. Plata, was argued this past Tuesday and the transcript is online.

This is relevant to a psychiatry blog because one of the arguments used in support of the releases is the contention that overcrowded facilities reduce access to mental health and medical services and that overcrowding causes mental deterioration and breakdown. The APA filed an amicus brief in the case, but the brief isn’t available online yet. (Keep an eye out for it here.)

The challenge with this case is that there is no (or extremely little) actual research to support the link between overcrowding and psychological problems. Correctional systems have spent a lot of time litigating issues — and experts make a fair amount of money working on these cases — without actual data. Read more »

*This blog post was originally published at Shrink Rap*

Physician Lifestyle Is Criteria When Choosing A Medical Specialty

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Medical students today consider lifestyle an essential criteria when choosing a specialty. It’s become a cliche that most are looking towards the ROAD (radiology, ophthalmology, anesthesiology and dermatology) to happiness.

There’s been some recent media attention at how women are lured to specialties that offer a greater balance between their family lifestyle and professional demands. Claudia Golden, a Harvard economics professor, recently noted that,

high-paying careers that offer more help in balancing work and family are the ones that end up luring the largest numbers of women. Surprisingly, colon and rectal surgery is one of these, because of rapid growth in routine colonoscopies that can be scheduled in advance, giving doctors control over their time. Goldin says 31% of colon and rectal surgeons under 35 years of age were female in 2007, compared with only 3% of those ages 55 to 64, and 12% of those ages 45 to 54, reflecting the fact that younger women are flocking to the field.

Of course, what’s not said is the grueling training that it takes to become a colorectal surgeon — but the numbers cited above do not lie. The new generation of doctors — both men and women — want greater control of their time. That means more shift-work and a predictable call schedule. Read more »

*This blog post was originally published at KevinMD.com*

Doctors’ Right To Freedom Of Speech

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Imagine having a medical device that is being tested in multiple centers, but one doctor thinks the device has problems. He says so at a national conference despite glowing reviews by others. Should the company sue the doctor for liable and remove him from their investigative panel?

Today, it seems that might not be such a good idea. This is, in fact, what NMT Medical did regarding comments made by Peter Wilmshurst, M.D. regarding NMT’s patent foramen ovale (PFO) closure device called Starflex:

NMT sued Dr. Wilmshurst for libel after he criticized its research at a US cardiology conference in 2007. The doctor vowed to take the case to trial in order to defend scientists’ rights to free academic debate.

The company threatened Dr. Wilmshurst with libel a second time for subsequent comments he made about the case on BBC Radio 4’s Today programme. Read more »

*This blog post was originally published at Dr. Wes*

Hand Or Arm Transplantation: When The Body Rejects It

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Dr. Richard Edwards, a chiropractor from Oklahoma and the nation’s third double-hand transplant, was recently in the news again. This time it a report that he “may lose the fingertips on his right thumb and pinkie because his body started to reject the new limbs.”

Dr. Edwards’ surgery was live tweeted when it was done in August by Louisville surgeons at The Jewish Hospital Hand Care Center.

Jeff Kepner, the first patient in the United States to receive two hands simultaneously, experienced an episode of rejection which was dealt with successfully.

Rejection is never a good thing in a transplant patient no matter which organ or body part is transplanted. Even though I applaud the advances being made, we must always consider the cost of the proposed treatment and ask: Is there a better option for this individual? Read more »

*This blog post was originally published at Suture for a Living*

Food Safety: Meat And Dairy From Cloned Cows?

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The controversy over the human consumption of meat and dairy products from cloned cows continues. The UK Advisory Committee on Novel Foods and Processes, after reviewing the evidence, concluded that there was no substantial difference between meat and dairy from cloned cows compared to conventional cows. However, food products from cloned animals and their offspring remain banned in Europe.

Use of offspring of cloned cows, sheep and pigs are legal in the U.S., South America, and Asia. Australia is likely to follow suit in a year or two. The European Union (EU) has an effective ban at the moment, but the policy is under review. The UK is also negotiating with the EU regarding the use of clones.

There is not much of a theoretical reason to suspect that cloned animals would present a health risk. The primary concern is that something unanticipated might have occurred during the cloning process, causing the animal to be genetically or developmentally abnormal. However, if the cloning process works properly this should not happen. Further, if mutations do occur but the animal lives, it is likely that any changes do not represent a risk to humans who consume the meat or dairy from such clones. Read more »

*This blog post was originally published at Science-Based Medicine*

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